Temporary Decompression of Symptomatic Epidural Hematoma via an In Situ Epidural Catheter: A Case Report
Rakesh V Sondekoppam1, Douglas Quan, Sugantha Ganapathy
1From the *Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada; †Department of Surgery, and ‡Department of Anesthesiology and Perioperative Medicine, Western University, London, Ontario, Canada.
Abstract:
Spinal epidural hematoma (SEH) following neuraxial anesthesia needs prompt recognition and early decompressive measures to prevent long-term neurologic injury. We report a case of SEH presenting on the second postoperative day during an ongoing epidural infusion. Aspiration of blood through the epidural catheter and a subsequent improvement in the neurological symptoms made us suspect SEH, which was further confirmed by an MRI study. We describe the timeline of the presentation of SEH and the subsequent clinical course in our patient. Aspiration of blood through an in situ epidural catheter may not only point toward the possibility of SEH but may also temporarily decompress the spinal canal.
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